What Do the Symptoms of RSV Really Look Like? Doctors Break It Down

Kaitlin Vogel
·4 min read
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Plus, how to tell the difference between a cold, the flu and COVID.

When it comes to viruses, many of us are most worried about COVID, whether it's out of habit or because cases are expected to rise in the next few months. But flu cases are also way up, and there's another virus to be aware of—especially if you’re a parent of young children.

Respiratory syncytial virus, more commonly referred to as RSV, is a virus that most people get before the age of two. If you’re in good health, RSV leads to cold-like symptoms that typically last a week. However, it can be dangerous in some cases, particularly among people who are immune compromised—and that group includes the elderly, toddlers and babies.

The Top RSV Symptoms To Look Out For

For most kids, RSV will cause the same symptoms as any other cold: runny nose, cough and maybe a fever. But for some, especially those under the age of two, RSV can congest the lungs, making it hard to breathe, explains Dr. Ali Alhassani, MD, the Head of Clinical at Summer Health. If this happens, you’ll notice your child is breathing faster, their nostrils could be flaring, their chest could be caving in with each breath and they could be grunting.

Related: Vanessa Lachey Recalls Watching Her Infant Son Battle RSV: 'It Rocked Us to the Core'

“The best thing any parent can do is to keep a baby’s nose suctioned out so that they can breathe,” says Dr. Kristina Deeter, MD, specialty medical officer for pediatric critical care at Pediatrix Medical Group. “If a baby’s nose is stuffed up, then they have a hard time breathing, taking a bottle or breastfeeding. At that point, a parent needs to watch closely for signs of fatigue and dehydration.”

How To Tell If It’s RSV, the Flu or COVID

RSV, the flu, and COVID can all present as cold-like symptoms: Fever, cough and congestion.

There are some symptoms like headache, loss of taste or smell, and sore throat that can point away from RSV, Dr. Alhassani states. But in young kids, it is often hard to know when these symptoms are happening, so it's helpful to get tested for the different viruses.

Related: Is It a Cold or COVID-19? Here's How to Tell the Difference

“Colds, the flu and COVID can all present with upper respiratory symptoms: congestion, cough, sneezing and sore throat," Dr. Deeter says. "The flu often progresses to increased symptoms of body aches, fevers and fatigue. COVID may cause increased symptoms with progressive cough and respiratory distress."

When To See a Healthcare Provider

With a "tripledemic" on the rise with the surge of RSV, the flu and COVID, parents might be more hesitant to go to a doctor’s office, which may mean long wait times and the possibility of getting infected with another virus. 

However, if your child’s symptoms are not resolving on their own after a few days, it might be time to consult with a pediatrician, Dr. Alhassani explains. You should see a provider sooner if your child is having significant trouble breathing or feeding, or if they are very drowsy.

Dr. Deeter says if a baby is having any trouble breathing or any spells when they have pauses in their breathing, then they should be taken in for evaluation. If a baby cannot feed well or has a decreased number of wet diapers, they should also be evaluated.

Treating RSV

“Unfortunately there are no medications that act specifically against the virus,” says Dr. Alhassani. “The best way to treat RSV is to provide supportive care. If the child is very congested, things like nasal suction, humidifiers or steam can help them feel a bit better. Tylenol and Motrin can help treat fevers. And lastly, making sure they are well-hydrated is key.”

For a small baby, the best thing to do is to keep their nose suctioned out and to continue to feed frequently. For an older child, treatment of aches with acetaminophen and increased fluids can help the symptoms, Dr. Deeter explains.

Avoid over-the-counter cough suppressants and decongestants, as these can just make children more dry and sometimes agitated. The best supportive treatment for most viruses is rest, pain relief, airway clearance and fluids.

Next up: How Long Does the Flu Last? Here's What It Means If You Feel Tired Weeks Later

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